Healthy Skepticism Library item: 12476

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Publication type: news

Schmidt MS.
Baseball Is Challenged on Rise in Stimulant Use
The New York Times 2008 Jan 16
http://www.nytimes.com/2008/01/16/sports/baseball/16stimulant.html

Full text:

When George J. Mitchell was appointed to investigate the use of performance-enhancing drugs in baseball nearly two years ago, amphetamines were not part of his mandate. The substances had been around baseball for decades, were sometimes winked at and were not even banned until the 2006 season, several years after the sport began to address what seemed to be the far larger controversy of steroid use.

Nevertheless, it was amphetamines that left baseball looking flat-footed Tuesday when Commissioner Bud Selig and the players union executive director Donald Fehr joined Mr.
Mitchell to discuss his report’s findings before the House Committee on Oversight and Government Reform.

Amid discussion of steroids and human growth hormone, amid an atmosphere more tame than tempestuous, it was Representative John F. Tierney, a Massachusetts Democrat, who caught everyone’s attention when he asked why the number of major leaguers claiming therapeuticuse exemptions for attention deficit disorder had mushroomed to 103 this past season from 28 in 2006.

To Mr. Tierney, the implication of the sharp increase was clear. Players were brazenly getting around the ban on amphetamines by making attention deficit disorder claims that allowed

Baseball Is Challenged on Rise in Stimulant Use – New York Times them to use stimulants like Ritalin and Adderall. Based on the 2007 numbers, Mr. Tierney said, the use of such stimulants among major leaguers was “almost eight times the adult use in our population.”

How, Mr. Tierney wanted to know, had baseball allowed this to happen?
“We are trying to break down why it happened and how it happened,” Mr. Selig said in response. Mr. Fehr suggested that the attention deficit disorder numbers might be higher in baseball than the general adult population because baseball players have a younger average age.
Both he and Mr. Fehr said they trusted the judgment of Dr. Bryan W. Smith, a North Carolina pediatrician with a doctorate in exercise physiology who administers baseball’s drug-testing program and has to approve any medical exemptions. He was not immediately available for comment after the hearing.

The Mitchell report runs 311 pages, but includes no mention of the therapeutic use exemptions that players have been granted since the exemptions were instituted for the
2006 season. Mr.
Mitchell apparently sought such numbers but was rebuffed. Robert DuPuy, baseball’s chief operating officer, said Tuesday night that the commissioner’s office was willing to let Mr.
Mitchell have the numbers, but that the players union objected.

Michael Weiner, the union’s general counsel, disagreed, saying both sides felt it “was not appropriate” for Mr. Mitchell to see the figures. But Mr. Weiner said that when the House committee asked for the numbers, both sides agreed to provide them.

In an interview in his office after Tuesday’s hearing, Mr. Tierney said the numbers arrived Monday night and committee staff members brought them to his attention Tuesday morning.

“When you see the number 28 one year go all the way to 103, it makes you think that we have a loophole here with performance-enhancing drugs,” Mr. Tierney said.
“We shouldn’t have to have hearings like this all the time to stay on top of these problems with baseball,” he added. “It was a good thing at least that Mr. Selig recognized the increase.”

Under the ban on amphetamines that was introduced in 2006, a player can test positive once without being publicly identified or suspended, but faces a 25-game suspension for a second positive test. Each player is tested twice a year for amphetamines.
In the two years since the test was put in, only two major leaguers – Mike Cameron and Neifi Pérez – have been suspended for amphetamine use. Two others, Barry Bonds and Jason Giambi, have been identified in news reports as having failed a single amphetamines test and neither has disputed those disclosures.

Major League Baseball has declined to state the number of players over all who have failed one test, although it is widely believed that dozens are in that category. The ban on amphetamines has clearly had an impact on clubhouses, with some players turning to caffeine-laden drinks.
But the numbers disclosed by Mr. Tierney suggest that other players are using attention deficit disorder as a means to use stimulants that are not available without a prescription and, since the beginning of the 2006 season, cannot be used by players without a medical exemption.

In fact, almost all of baseball’s therapeutic-use exemptions the last two seasons were for attention deficit disorder. In 2006, the 28 exemptions in those cases dwarfed the 7 other exemptions granted. In 2007, there were only eight other exemptions in comparison with the
103 for attention deficit disorder.

Dr. Gary I. Wadler, an internist and antidoping expert, said stimulants help a person concentrate – that is their medical link to attention deficit disorder – but also mask pain and increase energy and reaction time. He said side effects in adults could include heart attacks and severe anxiety.

Dr. Steven Safren, an associate professor of psychology at Harvard Medical School, said it was estimated that 2 to 6 percent of the adult population had attention deficit disorder.
Rob Manfred, baseball’s executive vice president for labor relations and the official most directly involved with the drug-testing programs, said Tuesday night that the commissioner’s office was not overly concerned about the increase in attention deficit disorder exemptions.

“Nobody really knows why it jumped,” he said, noting that 103 therapeutic-use exemptions out of a baseball population of 1,354 players in 2007 meant 7.6 percent of those players were claiming attention deficit disorder as an affliction, a percentage not that much out of line with the general adult population.

Dr. Safren, asked about baseball’s numbers, and the surge from 28 exemptions to 103 in one year, said: “It certainly is a big jump. It could be that people weren’t disclosing it. At the same time, the percentage is at the high end.”
Dr. Allan Lans, the Mets’ team psychiatrist from 1985 to 2003, was more blunt. “The No. 1 drug use of sports is really amphetamines,” he said. “Amphetamines are the real performanceenhancing drugs that people should always have been worried about.”
He said he was not surprised that players were seeking exemptions to use certain stimulants,

and were citing attention deficit disorder. “The ballplayers who are smart want a legal way to get amphetamines, not an illegal one,” he said. “The doctors are easily conned.”
Alan Schwarz contributed reporting from Washington.